Reporting of Conflicts of Interest of Panel Members Formulating Clinical Practice Guidelines in Anesthesiology: A Cross-sectional Study

Damien Wyssa,1 Martin R. Tramèr,1,2 Nadia Elia1,3

Objective Previous reports suggest that conflicts of interest (COIs) of panel members formulating clinical practice guidelines are common. Because COIs (both academic and financial) may bias the recommendations, solutions have been proposed and implemented, such as the exclusion of panel members with important COIs or involvement of a methodologist without such COIs. However, little is known about the reporting of these procedures in the published guidelines. Our aim was to describe the way COIs are reported among anesthesia guidelines.

Design In this cross-sectional analysis of all guidelines published in 5 anesthesiology journals from 2007 to 2016, we examined the number and proportion of guidelines that (1) reported and described the potential influence of the guideline sponsor; (2) reported on individual panel members’ COIs in the published guideline, and (3) did so in a clearly identified distinct paragraph; (4) included only panel members declaring a lack of COIs; (5) included a chair panelist declaring a lack of COIs; and (6) described procedures taken to minimize the risk of biases related to a panel member’s COIs.

Results Our search strategy identified 76 publications, of which 66 met our inclusion criteria. Seven guidelines (11%) reported that they had received no funding, 8 (12%) reported having received funding without explanation of the potential impact of the sponsor on the recommendations, 2 (3%) reported funding with an explanation on the influence it could have had on the development of the guideline, and 49 (74%) made no statement regarding the funding of the guideline. Thirty-four guidelines (52%) reported on the panel member’s COIs in the published report; 15 of 66 (23%) did so in a distinct paragraph with a subtitle mentioning the term “interest.” Ten guidelines (11%) included only the panel member’s statement declaring no COIs. Chairs of 35 guidelines (53%) were identified, of whom 8 reported a lack of COIs. Finally, 2 guidelines (0.3%) described measures taken to decrease the risk of biased recommendation related to the panel member’s COIs.

Conclusion Although COIs of panel members are reported in about half of the published guidelines in anesthesia, the description of the COI and its potential influence on the guideline recommendation remains poorly documented. Standardized ways of reporting COIs of guideline panel members are required.